Under new model, patients placed in jeopardy 74 percent of the days studied
From the Massachusetts Nurse Newsletter
April 2010 Edition
This is the first in a series of reports the MNA negotiating committee at Tufts Medical Center will provide as we continue our campaign to reverse the misguided and dangerous staffing practices being forced upon nurses by our management team. While the new model of care went into effect officially on Jan. 25, on a number of units, the changes to the staffing grids occurred in September, which explains why we have chosen this time frame for our first report. The findings from these reports are shocking, and include a number of harrowing incidents that have resulted in serious harm to our patients. This data and anecdotes we are gathering will soon be shared with our Board of Trustees, and if need be, the public, as these practices are tantamount to nursing malpractice perpetrated by our nursing leadership.
Key findings
Review of all unsafe staffing reports filed from Sept. 11, 2009 to March 9, 2010 reveals a total of 132 reports over 179 days. This averages out to 74 percent of days in this time frame reported to be unsafe by nursing staff.
Of the 132 reports only 31 of them (or 23 percent) proved to be “at” minimum staffing quotas as set by administration. The other 99 reports (or 76 percent) showed the unit to be running “below” minimum staffing quotas at the time of the unsafe event.
In these reports acuity is recorded as well as staffing levels. 57 percent of the reports showed acuity on the floor at the time was higher than average for the floor (minimum staffing grids do not allow increases in staffing numbers for acuity).
Of the 132 reports, 69 (55 percent) detailed an existing hole in the schedule as an underlying cause.
Only nine reports (7 percent) showed that ill calls contributed to the staffing problem.
The most common theme throughout many of these reports was the mandating of admissions or flexing up of beds, where nurses are forced to accept additional patients beyond what they are staffed for because of increased census. Flexing up was noted in 34 reports (26 percent) of the unsafe events recorded. 33 percent of the reports cited mandatory overtime, where nurses were forced to work double shifts. We want to thank all those who have taken the time to fill out unsafe staffing reports, and encourage all nurses to fill out a form anytime they feel conditions prevent them from delivering the care their patients need to be safe. Documenting the reality of this crisis is essential to our effort to address it.
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